---

Abstract Background and purpose: The aim of this study was to compare closed and open hemorrhoidectomy techniques, regarding postoperative signs, symptoms, and complications, and long-term results. Materials and methods: This was a randomized clinical trial conducted on 100 patients with third-or fourth-degree hemorrhoids suitable for hemorrhoidectomy. Group A contained 50 patients whom underwent open hemorrhoidectomy and 50 patients in group B underwent closed hemorrhoidectomy. Patient information including type and length of operation, postoperative complications, and length of hospital stay were recorded. Follow-up was done at 6 hours, 24 hours, 14 days and 28 days after the operation and postoperative pain was compared in both groups. Results: Findings indicated that mean hospital stay was 2.1 ± 0.82 days in group B, while the figure was 1.2 ± 0.4 days in group A. Thus, there was a statistically significant difference between the two methods in this regard (P<0.05). However, no significant differences were found regarding pain, need for analgesic drug, operation length and wound healing duration. There were no cases of incontinence, stricture and need for surgery and rehospitalization in both groups. The difference between postoperative complications were not statistically significant (P>0.05). Conclusion: Both methods are fairly efficient treatments for hemorrhoids, with similar effects and without any serious drawbacks. Nonetheless, the closed method has one advantage over open alternative and that is the shorter postoperative stay for the patients.